The efficacy and safety of high‐dose amoxicillin‐bismuth‐potassium competitive acid blocker therapy for Helicobacter pylori infection—A pilot study
Abstract
Abstract Recent developments in Helicobacter pylori ( H. pylori ) treatment have highlighted the rising resistance to clarithromycin. Conversely, amoxicillin resistance remains relatively low in both first‐line and rescue treatments. Evidence has shown that the effectiveness of high‐dose amoxicillin/proton pump inhibitor dual therapy varies in different countries. The effectiveness of combining high‐dose amoxicillin with potassium‐competitive acid blocker (PCAB) and bismuth as a mono‐antibiotic strategy for H. pylori eradication remains to be determined. To assess the efficacy and safety of a 14‐day regimen combining bismuth, high‐dose amoxicillin, and PCAB (Bap therapy) as both first‐line and rescue treatment for H. pylori infection, and to identify the factors that affect the outcome of this novel therapeutic approach. We conducted a retrospective cohort study of patients with H. pylori infection treated with Bap therapy from January 2021 to March 2024 across four hospitals in Taiwan. The regimen consisted of tripotassium dicitrato bismuthate (300 mg four times daily), high‐dose amoxicillin (750 mg four times daily), and vonoprazan (20 mg twice daily) for 14 days. Patients returned in the second week to assess drug adherence and adverse events. Post‐treatment H. pylori status was assessed at least 4 weeks following Bap therapy. Fifty‐one patients receiving Bap therapy as either first‐line ( n = 45) or rescue treatment ( n = 6) were analyzed. Eradication rates in first‐line…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 45 participants or records.
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